In addition to all the “self-care” I talked about last week, a huge part of treatment for bipolar disorder is medication. Typically your medication will be prescribed by your psychiatrist, but if you don't have one then they can also be prescribed by your general practitioner / family doctor. There are many types of bipolar medication. The most common are mood stabilizers (such as Lithium). Anti-convulsants – originally created for epilepsy are now used as mood stabilizers (such as Epival). Then there are anti-psychotics – these are most beneficial during mixed episodes and depression (such as Abilify). Also among the prescribed medications are anti-depressants (such as Remeron and Wellbutrin). Doctors are careful in prescribing anti-depressants to bipolar patients for it can create a manic mood. The use of mood stabilizers can help resist this effect. And finally there is the use of anti-anxiety or sleep aids (such as Clonazepam or Ativan). Most bipolar patients take a combination of the above drugs – often referred to as their medication “cocktail.” It can take a long time to find the right cocktail – for me it was 8 years – not uncommon. Not only do you have to find the right combination of medication but the dosages have to be right as well. Then there is your own illness and the changes that occur in your brain. As things change, medication adjustments need to be made. It's an ongoing battle. Right now my cocktail consists of six different meds (not to mention the ones for side effects) – some people have more and the lucky ones have found a way to balance their moods with less. It can be very frustrating taking so many medications. There are times when I have thrown my pill case across the room. Then there are the side effects to deal with. Some of those require even more medication. Some make your life difficult like weight gain and nausea. It is important to educate yourself about each of your medications and their side effects. But the bottom line is to work with your doctor to find the best cocktail for you – then stick with it. Never change your medication without talking to your doctor first. Compliance is important.

Often over-looked, self-care is one of the most important caring relationships for bipolar disorder that there is. How you are with yourself and what you do with yourself are the building blocks to your health. There are so many aspects of self-care. Start with a routine. Whatever your routine is – stick with it. Routine is valuable for bipolar disorder. Some of the foundations to self-care include: nutrition, sleep and exercise. Nutrition fuels your body and gives you what energy you have. Sleep is critical – too much can signal a depression, while too little can contribute to mania. Exercise doesn't have to be excessive; a gentle walk around the block can help you feel better. Avoid alcohol and non-prescribed drugs. Education is a key component in self-care. Read all you can read – learn all you can learn about bipolar disorder. It will serve you well. Education will help you understand your illness. And understanding will help you care for yourself better. It is critical to stick to your treatment plan. That entails attending all your medical and therapy appointments. It includes your psychiatrist, your general practitioner, your therapist, group therapy if you do that, and most importantly, staying on your medication as directed. A mood diary can be a helpful tool in illustrating your moods. Not only does it help you identify your moods but it can assist your psychiatrist as well. Learn to identify your own triggers and symptoms – everyone is different. Build a support system – that not only includes your doctors and therapists but it should also include key family and friends – people who understand and care about you. And most importantly, be kind to yourself. Show yourself the compassion you would to others. You deserve it.

Sharing on Twitter and Facebook has become second nature for many people, myself included. I post different things on Facebook than I tweet on Twitter. I have some friends on Facebook that I “talk” to regularly – some every day. Some that I haven't even met in real life. I belong to a couple of bipolar groups on Facebook, and they are interesting. But mostly, for me, Facebook is about friends and family that I know. So, when I make a post I have to always be mindful of who will be reading it. Since the start of this blog; however, that now matters to me less. Yet still I do censor myself. Twitter is a different situation. I know very few of my followers and therefore find it easy to tweet very personal information. It's a good outlet in that respect. Mostly I tweet quotes – but they are quotes that are relevant to how I'm currently feeling. The other day I made a very personal tweet and to my surprise got a very personal response – from a stranger. It helped. Also there is a large following of people interested in mental illness and I find it comforting knowing they're there. It's helpful reading their tweets. The blend of comradeship and anonymity between Facebook and Twitter can assist in managing the loneliness associated with bipolar disorder. Knowing there are others to reach out to is helpful. Social media has become part of my day, and part of my personal support system.

Spending sprees are a hallmark symptom of bipolar disorder and many people have been known to buy cars or houses – big ticket items. Fortunately I never spent at that level, but that's not to say that my spending didn't cause harm with our finances or arguments with my spouse – they surely did. There are so many instances I could write about but one in particular comes to mind more than others. My car went into “auto-pilot” and drove to our local Michaels store – the largest craft store I've ever seen. I parked the car and went in, thinking I'd just pick up a few items. No such luck. I grabbed a shopping cart, which was the first bad sign. The pressure to buy built as I rounded the corner of each aisle of the store. Up and down the aisles I went piling my cart higher and higher. My excitement mounted as did the bill. By the time I went through the cash the total had climbed to just over $900. I carried the numerous bags out to my car, put them in the trunk and jumped into the driver's seat. Then I burst into tears. I panicked. I didn't know what to do. I drove home in quite the state and called my mom as soon as I got there. I relayed the story to her and she immediately came over. She took the bags and the receipt back to the store. She returned everything for me without incident. I could breathe again. Til next time.